title: Plurifocal breast cancer and double lymphatic spread.
abstract: BACKGROUND
  Sentinel node (SN) has been proved to be a reliable technique in predicting the lymph nodes state of the axilla in breast cancer. For the majority of the authors the intradermal and peritumoral injection is the best way.
  
  
  METHODS
  Our experience, from 1997, includes 587 cases of SN in women with resectable breast cancer less than 3 cm of diameter. We performed the lymphoscintigraphy after a peritumoral injection of radioactive tracer and, if the lesion was superficial, we associated an intradermal injection on the skin above the lesion itself. Two patients had multifocal right breast cancer. We did two separate injections around each tumor.
  
  
  RESULTS
  The radioactive tracer spread towards the internal mammary chain and homolateral axillary nodes.
  
  
  CONCLUSIONS
  We consider the peritumoral injection as essential in tumors located deeply in the breast (under ultrasound guide if not palpable) together with intradermal injection in superficial ones. Using this technique the possibility of a mis-identification of the SN is reduced.
authors.affiliation: Second University of Naples, Department of General and Specialistic Surgery, Naples.
authors.forename: R
authors.initials: R
authors.lastname: Ruggiero
authors.forename: E
authors.initials: E
authors.lastname: Procaccini
authors.forename: V
authors.initials: V
authors.lastname: Cuccurullo
authors.forename: L
authors.initials: L
authors.lastname: Mansi
authors.forename: S
authors.initials: S
authors.lastname: Gili
authors.forename: C
authors.initials: C
authors.lastname: Cremone
authors.forename: G
authors.initials: G
authors.lastname: Docimo
authors.forename: L
authors.initials: L
authors.lastname: Docimo
authors.forename: L
authors.initials: L
authors.lastname: Sparavigna
authors.forename: A
authors.initials: A
authors.lastname: Gubitosi
authors.forename: F
authors.initials: F
authors.lastname: Iovino
authors.forename: D
authors.initials: D
authors.lastname: Parmeggiani
authors.forename: N
authors.initials: N
authors.lastname: Avenia
mesh_terms: D000328:Adult; D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D013668:Technetium Tc 99m Aggregated Albumin; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin